Publication:
Antimicrobial use and resistance data in human and animal sectors in the Lao PDR: Evidence to inform policy

Issued Date

2021-12-01

Resource Type

Article

ISSN

20597908

DOI

10.1136/bmjgh-2021-007009

Other identifier(s)

2-s2.0-85121251918

Rights

Mahidol University

Rights Holder(s)

SCOPUS

Bibliographic Citation

BMJ Global Health. Vol.6, No.12 (2021)

Suggested Citation

Vilada Chansamouth, Mayfong Mayxay, David A.B. Dance, Tamalee Roberts, Rattanaxay Phetsouvanh, Bouakham Vannachone, Manivanh Vongsouvath, Viengmon Davong, Phout Inthavong, Syseng Khounsy, Bounxou Keohavong, Valy Keoluangkhot, Khamla Choumlivong, Nicholas P.J. Day, Paul Turner, Elizabeth A. Ashley, H. Rogier Van Doorn, Paul N. Newton Antimicrobial use and resistance data in human and animal sectors in the Lao PDR: Evidence to inform policy. BMJ Global Health. Vol.6, No.12 (2021). doi:10.1136/bmjgh-2021-007009 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/77462

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Title

Antimicrobial use and resistance data in human and animal sectors in the Lao PDR: Evidence to inform policy

Author(s)

Vilada Chansamouth
 Mayfong Mayxay
 David A.B. Dance
 Tamalee Roberts
 Rattanaxay Phetsouvanh
 Bouakham Vannachone
 Manivanh Vongsouvath
 Viengmon Davong
 Phout Inthavong
 Syseng Khounsy
 Bounxou Keohavong
 Valy Keoluangkhot
 Khamla Choumlivong
 Nicholas P.J. Day
 Paul Turner
 Elizabeth A. Ashley
 H. Rogier Van Doorn
 Paul N. Newton

Other Contributor(s)

Faculty of Tropical Medicine, Mahidol University
 Oxford University Clinical Research Unit
 Ministry of Health Laos
 London School of Hygiene & Tropical Medicine
 Mahosot Hospital, Lao
 Nuffield Department of Medicine
 Cambodia Oxford Medical Research Unit
 University of Health Sciences
 Ministry of Agriculture
 Setthathirath Hospital

Abstract

Objectives To review the scientific evidence base on antimicrobial use (AMU) and antimicrobial resistance (AMR) in human and animal sectors in the Lao PDR (Laos). Methods We reviewed all publications from July 1994 (the first article describing AMR in Laos) to December 2020. Electronic searches were conducted using Google Scholar and PubMed with specific terms relating to AMR and AMU in Lao, French and English languages. Findings We screened 1,357 peer-reviewed and grey reports by title and abstract and then full articles/reports. Of 80 included, 66 (83%) related to human health, nine (11%) to animal health, four (5%) to both animal and human health and one (1%) to the environment. Sixty-two (78%) were on AMR and 18 (22%) on AMU. Extended spectrum beta lactamase-producing Escherichia coli was the greatest concern identified; the proportion of isolates increased fivefold from 2004 to 2016 (2/28 (7%) to 27/78 (35%)) from blood cultures submitted to the Microbiology Laboratory, Mahosot Hospital, Vientiane. Carbapenem resistant Escherichia coli was first identified in 2015. Methicillin-resistant Staphylococcus aureus (MRSA) was uncommon, with 15 cases of MRSA from blood cultures between its first identification in 2017 and December 2020. AMR patterns of global antimicrobial resistance surveillance system (GLASS) target pathogens from livestock were less well documented. There were few data on AMU in human health and none on AMU in livestock. The first hospital AMU survey in Laos showed that 70% (1,386/1,981) of in-patients in five hospitals from 2017 to 2018 received antimicrobial(s). Antibiotic self-medication was common. Conclusion AMR in Laos is occurring at relatively low proportions for some GLASS pathogens, giving the country a window of opportunity to act quickly to implement strategies to protect the population from a worsening situation. Urgent interventions to roll out new guidelines with enhanced one-health antibiotic stewardship, reduce antibiotic use without prescriptions, enhance surveillance and improve understanding of AMU and AMR are needed.

Keyword(s)

Medicine

Availability

URI

https://repository.li.mahidol.ac.th/handle/20.500.14594/77462

Collections

Scopus 2021